Split dose Lantus Experiment

[klpants]

Hi Everyone

For those on Lantus and interested, I've changed to two equal doses of Lantus, one in the morning before breakfast and one in evening before bed instaed of the one dose before bed.
I'm only on day three but the results are good so far. My night time blood sugar last night was 5.5mmol aprox 99mg/dl and all day today BSs of 5.5mmol - 7.7, and no corrections!! (99mg/dl - 126 mg/dl) (keeping in mind all the different factors (exercise, food intake, routine)

The reasons I thought about making this change was the low bs in the night and a rise in BS after about 4pm and lots of corrections with the Humalog.

I'll post more results later when I've been on this regimen for at least a week.

Just thought someone out there may like to try the same thing?

Feeling good!

:thumbsup:

[grace girl]

I'm on the same meds as you, so I'll be following your progress with great curiosity. I've been wondering about splitting my lantus for a while now. The endo had me up my lantus dose again last night, and I woke up at 74 this morning, which promptly dropped to 69 upon arising, and I started having symptoms. I hate morning lows the most because I don't recognize them that well, and I find myself getting really aggrivated at the thought of dealing with it. Not a great way to get up!
It never occurred to me that splitting the dose could stop morning lows.

[klpants]

I'll keep you posted on what happenns!

The split dose occured to me as I don't think on Lantus I'm covered for a full 24 hours more like 18 (guess depends on everyone), this is why I was having rising BS at 4pm onwards and the lows in the night when Lantus is working the most (even thougth Lantus isn't supposed to have a peak, I still think the effects are most during the first 10 hours)

I figure if I've delayed the two doses I have Lantus in my system, a full 24 hours, give or take!!

[poodlebone]

I had to split my Lantus when I was taking it as well. Definitely worked out better with 2 shots, as I had the same problems as you. I'd go low at night, high by late afternoon.

[grace girl]

I've stopped having afternoon highs as they have increased my dose, but more and more morning lows. I know they say it doesn't peak, but they haven't convinced me yet!

[jenet]

I've stopped having afternoon highs as they have increased my dose, but more and more morning lows. I know they say it doesn't peak, but they haven't convinced me yet!
Actually it does peak, sometime around the 8 hour mark if I remember right. (Someone will come along and correct me if I've got the timing wrong.) And I'm in the middle of reading the updated Pumping Insulin book, which references a study indicating up to 1/3 of people on Lantus are splitting doses to extend the coverage, which commonly does NOT last 24 hours. I have read that the peaking and less than 24 hour coverage are more pronounced the larger the dose of Lantus. YMMV

cheers,
j

[DCK]

For me (Type 1 20 years, Lantus User 2 years) it has always been "Peaky" and I have never enjoyed a 24 hour duration. I switched to a morning/evening dose with 50/50 split about a week after using it and until recently that has worked fairly well. Most overnights it drops me by >100 points or so, which is always a source of concern. My mornings can be 60~85 (which is much lower than I ever got with NPH) but some days will be much higher without apparent reason.

But my impression is that I get a peak at about 5.5 hours after injection and that it is more or less metabolized in 10~12 hours. One other oddity for my own case, I use a Medi-Jector and I have often wonder is the rate of breakdown might be effected by the this injection method.


My reason for posting today is that I wonder if any of you have seen the peak point or the durations change in your use of Lantus. The last week or so my control has been off for reasons I can not explain it and am wondering of my body is reacting differently to Lanus all of a sudden.

[klpants]

My reason for posting today is that I wonder if any of you have seen the peak point or the durations change in your use of Lantus. The last week or so my control has been off for reasons I can not explain it and am wondering of my body is reacting differently to Lanus all of a sudden.[/QUOTE]


I've not really noticed any difference in the peak points, usually about 8-10 hours fo rme and lasts about 18-20 hours.
Now, I've been ill today and it seems both my Lantus and Humalog aren't working at all (oh the joy of being sick and diabetes!) Have you been sick? Is that why you've been having problems with your Lantus?

[seacomp]

It's a minor point but worth noting. When you take a single daily dose of Lantus, any disruption to your schedule is far more serious than if you are taking two.
For example, assume you were taking one shot of Lantus at 10 pm. If you got delayed coming home and couldn't take it until 12, or if you forgot and skipped it altogether, you would go a shorter or longer time with no basal coverage at all.
Whereas, if you were on two doses, you'd have about half basal coverage for the missed period.
I keep rather irregular hours, and this is important for me.

[klpants]

Thanks Seacomp, I was wondering about that too!


It's a minor point but worth noting. When you take a single daily dose of Lantus, any disruption to your schedule is far more serious than if you are taking two.
For example, assume you were taking one shot of Lantus at 10 pm. If you got delayed coming home and couldn't take it until 12, or if you forgot and skipped it altogether, you would go a shorter or longer time with no basal coverage at all.
Whereas, if you were on two doses, you'd have about half basal coverage for the missed period.
I keep rather irregular hours, and this is important for me.

[gettingby]

I have been using split dosing with my Lantus for a while now and I think it was the best decision I could have made. I stopped my 2-3AM lows and I feel so much better when I wake up in the morning. I do mine at 7:30AM and 7:30PM. YMMV.

[Simon]

When I was on 8 units of Lantus a day I would sometimes notice that if I was lower than normal in the morning I would be higher than normal in the evening. This suggested the Lantus was being used up faster on some days than others. I dropped to 6 units with the intension of taking the other 2 in the morning and gradually moving over to 50/50. What I found was my bs was more stable on just 6 units so I stuck with just that in the evening. I sometimes take it late by 2 hours or more but since I usually eat late I will have some rapid acting insulin in my system to tide me over.

[Penny]

I experimented with splitting, too. At first, I split my 70 units of Lantus, 35/35 morning and bedtime. My fasting levels stayed very high. I went to 40/30, and they were still way too high. Now I do 70, at 11pm, and 20 at 11am. Fasting levels are still too high, but much lower than before, and my levels throughout the day are great.
I did find out if I can wake an hour and a half earlier, (5:30 instead of 7), eat and take medications, my fasting levels are good, and I stay good all day. Just can't manage on less than the 6 hours I usually sleep now.

[klpants]

it's good to see that others have also experimented with split dose Lantus. I wonder why one dose works for some but not others?, just physiological factors I guess?

[klpants]

Been on the split dose now for three weeks, best thing I've ever done!!!

My total insulin requirement has been reduced, my PM BS are superb and also I've not had a low in the night since starting and still waking up on a 4.0mmol (72mg/dl) fasting BS!

I'm not having to do loads of corrections in the PM and seem to be able to eat a bit more without having to inject insulin.

When I go on my AM run I'm also not having the spikes in BS that early morning exercise sometimes results in.

So all in all, great! I'd defiantely reccomend to someone having the same problems with Lantus as I had!!:biggrin: